46 STRANGLES 



is a rise of temperature. There is loss of appetite, depression, 

 and often great weakness. The general symptoms may con- 

 tinue for a few days before the localization of the lesions is 

 apparent. The first local manifestation consists usually in a 

 catarrh of the nasal mucosa or swelling of the sub-maxillary 

 and pharyngeal lymphatic glands. The nasal discharge is at 

 first serous and somewhat viscid, but in from*3 to 5 days it be"- 

 comes purulent and of a yellowish- green color. The catarrhal 

 condition may exist in one or both nostrils. It may extend 

 into the pharynx, larynx, trachea and even to the bronchi. In 

 most cases, swelling of the sub- maxillary glands appears con- 

 currently with the purulent ng-sal catarrh. The spreading of 

 the inflammation to the connective tissue which surrounds the 

 glands, and the stasis of the lymph in the efferent lymph 

 vessels, often cause the development, from the sub-maxillary 

 lymph glands, of very extensive swellings that may occupy 

 the entire inter-maxillary space, and may spread even to the 

 outer side of the maxilla. Abscesses form in most cases. 



In exceptional cases, strangles may present catarrhal 

 symptoms without suppuration of the lymph glands. Jensen 

 states that it may first assume the form of pharyngitis, purulent 

 pneumonia, and pleuritis without any well marked morbid 

 affection of the lymph glands. The urine generally remains 

 alkaline ; it frequently contains a considerable quantity of 

 albumen. 



At times, strangles is accompanied by a cutaneous exan- 

 thema which takes the form of an eruption of wheals', nodules, 

 vesicles and even pustules ; these may appear, chiefly on the 

 sides of the neck, shoulders and sides of the chest. These 

 exanthemata are characterized by their sudden appearance, 

 and often by their equally rapid disappearance. An eruption 

 of vesicles may break out on the nasal mucous membrane. 

 The contents of the vesicles is at first limpid, but later it 

 becomes purulent. Rabe states that the streptococcus of 

 strangles can produce ulcers on the nasal mucous membrane. 



§ 27. Morbid anatomy. The lesions in strangles are 

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